Indiana

The grounds, as Indiana describes them

410 IAC 16.2-3.1-12(a)(4), "Transfer and discharge rights" (Indiana Department of Health (PDF), rule history line ends readopted filed Nov 13, 2019, retrieved 2026-09-13), states that health facilities "must permit each resident to remain in the facility and not transfer or discharge the resident from the facility unless", in the rule's own order:

"the transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility;"

"the transfer or discharge is appropriate because the resident's health has improved sufficiently so that the resident no longer needs the services provided by the facility;"

"the safety of individuals in the facility is endangered;"

"the health of individuals in the facility would otherwise be endangered;"

"the resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility; or"

"the facility ceases to operate."

The department's own prescribed notice, State Form 49669 (R8 / 1-19), restates the same six bases as checkboxes under the heading "Reason for Transfer or Discharge (Must select one of the reasons below.)", including "The transfer or discharge is necessary to meet the resident’s welfare and the resident’s needs cannot be met in the facility." — the form's own wording differs slightly from the rule's ("necessary to meet the resident's welfare" against "necessary for the resident's welfare"); both stand as published.

The published process

Requesting the hearing

410 IAC 16.2-3.1-12(a)(12): "The department shall provide a resident who wishes to appeal the transfer or discharge from a facility the opportunity to file a request for a hearing postmarked within ten (10) days following the resident's receipt of the written notice of the transfer or discharge from the facility." Subdivision (13): "If a facility resident requests a hearing, the department shall hold an informal hearing at the facility within twenty-three (23) days from the date the resident receives the notice of transfer or discharge." "The facility must convince the department by a preponderance of the" "evidence that the transfer or discharge is authorized under subdivision (4)." The pendency statement, subdivision (10): "If the resident appeals the transfer or discharge, the facility may not transfer or discharge the resident within thirty-four" "(34) days after the resident receives the initial transfer or discharge notice, unless an emergency exists as provided under" "subdivision (8)."

The hearing-request form, State Form 49831 (R8 / 4-23), directs the resident to send it "along with the Notice of Transfer or Discharge (State Form 49669) to the Department of Health within" "ten (10) days of your receiving the notice of transfer or discharge from the facility" to "Indiana Department of Health" "Court Administrator, Office of Legal Affairs" "2 North Meridian Street – Section 3-H" "Indianapolis, Indiana 46204", "Or" by email to "CourtAdministrator@health.in.gov". No filing fee or filing form other than State Form 49831 is stated in the sources reviewed.

The notice's required contents

410 IAC 16.2-3.1-12(a)(9): "For health facilities, the written notice specified in subdivision (7) must include the following:" — "(A) The reason for transfer or discharge."; "(B) The effective date of transfer or discharge."; "(C) The location to which the resident is transferred or discharged."; a statement "in not smaller than 12-point bold type that reads," the resident's appeal right in full, quoted in the docket above; "(E) The name of the director, address, telephone number, and hours of operation of the division."; "(F) A hearing request form prescribed by the department."; "(G) The name, address, and telephone number of the division and local long term care ombudsman."; and, "(H) For facility residents with developmental disabilities or who are mentally ill, the mailing address and telephone" "number of the protection and advocacy services commission."

The form the resident actually receives, State Form 49669, carries the same appeal-rights paragraph with its own citation form: "unless" "the facility is authorized to transfer" "you as an emergency transfer under 410 IAC 16.2-3.1-12(a)8." and directs questions to "the Indiana State Department of Health at 317-233-7540" "between the hours of 8:15 am and 4:45 pm." The form also requires the facility to attach "the facility’s bed hold policy to this Notice of Transfer or Discharge and provide" the bed-hold contact, and to include, for residents "who are mentally ill or" "developmentally disabled", the contact for "Indiana Disability Rights" at "4701 North Keystone Avenue, Suite 222" "Indianapolis, IN 46205", "Voice 1-800/622-4845 or 317/722-5555", "TTY 1-800/838-1131; Fax 317/722-5564".

Bed-hold and return

410 IAC 16.2-3.1-12(a)(25): "Before a facility transfers a resident to a hospital or allows a resident to go on therapeutic leave of twenty-four" "(24) hours duration or longer, the facility must provide written information to the resident and a family member or legal representative" "that specifies the following:" "(A) The duration of the bed-hold policy under the Medicaid state plan during which the resident is permitted to return" "and resume residence in the facility." and "(B) The facility's policies regarding bed-hold periods, which must be consistent with subdivision (27), permitting a" "resident to return." Subdivision (26): "Except in an emergency, at the time of transfer of a resident for hospitalization or therapeutic leave," a facility must provide "written notice which specifies the duration of the bed-hold policy" "described in subdivision (25)." Subdivision (27): "Medicaid certified facilities must establish and follow a written policy under which a resident, whose hospitalization or" "therapeutic leave exceeds the bed-hold period under the state plan, is readmitted to the facility immediately upon the first" "availability of a bed in a semiprivate room if the resident:" "requires the services provided by the facility; and" "is eligible for Medicaid nursing facility services."

The rule's own state-plan cross-reference is answered by the Indiana Health Coverage Programs' Provider Reference Module for long-term care facility services (Library Reference Number PROMOD00037, published May 12, 2026, policies and procedures as of Aug. 1, 2025), under the heading "Leave Days in a Nursing Facility": "The IHCP does not reimburse for bed-hold days in an NF as a member benefit unless the member is under" "the care of hospice." "There is no requirement that NFs hold beds." "An NF is required to follow a written policy under which a resident, whose hospital or" "therapeutic leave exceeds Medicaid coverage limitations, is readmitted to the facility upon the first" "availability of a bed in a semiprivate room, if the resident requires NF-level services and is eligible for" "Medicaid NF services." "Because Medicaid does not pay to hold beds in NFs except for hospice care, all bed holds for days of" "absence are considered noncovered services for which the resident may elect to pay." The module states plainly that a facility "must inform a resident in writing prior to a hospital transfer or departure for therapeutic leave" "that Medicaid does not pay for bed holds" and must "also communicate its policies regarding bed-" "hold periods." The two publishers are shown together rather than reconciled: the rule directs a facility to disclose "The duration of the bed-hold policy under the Medicaid state plan" as a state-plan matter, and the state's own Medicaid module states that no such paid duration exists outside hospice care — the disclosed duration, where one exists at all, is the facility's own private bed-hold policy, not a state-plan payment period.

The three rows above hoist the questions a facility's counsel answers in the first fifteen minutes. They are quotations from Indiana's published sources, not a determination that any of them applies to any situation.

Notice periods and deadlines, as stated in the sources

All quoted; none calculated.

Thirty days' advance notice — 410 IAC 16.2-3.1-12(a)(7): the notice of transfer or discharge "must be made" "by the facility at least thirty (30) days before the resident is transferred or discharged."

As-soon-as-practicable exceptions — subdivision (8): "Notice may be made as soon as practicable before transfer or discharge when:" the safety or health of individuals in the facility would be endangered, the resident's health improves sufficiently to allow a more immediate transfer or discharge, an immediate transfer or discharge is required by the resident's urgent medical needs, or "a resident has not resided in the facility for thirty (30) days."

Ten days to request a hearing — subdivision (12), quoted above in full; State Form 49831 states the same period as "within" "ten (10) days of your receiving the notice of transfer or discharge from the facility".

Twenty-three days to the informal hearing — subdivision (13): the department "shall hold an informal hearing at the facility within twenty-three" "(23) days from the date the resident receives the notice of transfer or discharge". Subdivision (13) also states the department "shall attempt to give at least" "five (5) days written notice to all parties prior to the informal hearing."

Thirty-four days before transfer if the resident appeals — subdivision (10), quoted above in full; the same figure appears in the notice's own appeal-rights paragraph.

Thirty days for the department's decision — subdivision (13): the department "shall issue a decision within thirty" "(30) days from the date the resident receives the notice."

Twenty-four hours of therapeutic leave triggering the bed-hold disclosure — subdivision (25): "Before a facility transfers a resident to a hospital or allows a resident to go on therapeutic leave of twenty-four" "(24) hours duration or longer, the facility must provide written information" to the resident and family member or legal representative specifying the bed-hold policy, quoted above in full.

What any of these periods means for a particular case is for the hearing office to determine.

Source map

Captured: all five, in tools/packets/indiana-packet.txt. Pending: the department's Resident Transfer and Discharge Information Center page (returns HTTP 404 at the address found) and the hearing's own procedural rules beyond what 410 IAC 16.2-3.1-12 itself states — per the packet's pending list.

Change log

2026-09-13 — Deepened to a full page. Newly captured: the Indiana Health Coverage Programs' Provider Reference Module for Long-Term Care Facility Services (source 5), sliced to its "Leave Days in a Nursing Facility" section by curl with a browser user-agent and pdftotext -layout, matching this recipe's existing transport. The recipe's four standing sources were recaptured in the same pass (tools/recipes/indiana.json, digest 00175a9654b0) and promoted as a rebuild; none of the four required a new transport. Section 01 (the grounds) and section 02 (the published process, including the notice's required contents in full, bed-hold and return, and the notice-periods register) are now written.

Findings, continuing the numbering from 2026-08-30: (7) The rule requires a facility to disclose "The duration of the bed-hold policy under the Medicaid state plan" as a state-plan matter, but the state's own Medicaid provider module states that the IHCP "does not reimburse for bed-hold days in an NF as a member benefit unless the member is under" "the care of hospice" and that "There is no requirement that NFs hold beds" — so outside hospice care, the duration a facility discloses under the rule is the facility's own private policy rather than a state-plan payment period. Both are quoted as published, reconciled nowhere. (8) The rule's grounds subdivision (4) and the notice form's checkbox list differ in wording though not in substance — the form reads "necessary to meet the resident's welfare" where the rule reads "necessary for the resident's welfare"; both stand as published. (9) Recapturing the ombudsman contact page (source 4) on this pass found it shorter than the 2026-08-30 capture — a county-level entry present in August (a St. Joseph County local ombudsman's name, email, and phone) no longer appears; nothing this page quotes drew from that entry, and the retained capture history holds both versions. Capture pending: per the source map. Internet Archive: not yet submitted for the new source. Reviewer: Carrie Schluter, reviewed 2026-09-15. Corrections: hello@fieldassembly.net.

2026-08-30 — Baseline page built from the first Indiana packet: docket, lede, source map, change log. Not yet captured or written: section 01 (the grounds, as Indiana describes them) and section 02 (the published process, including the notice's required contents in full, bed-hold and return, and the notice-periods register). Findings: (1) Indiana prescribes both the notice and the appeal form, so the notice contents, the appeal route and three separate periods — ten days to request, twenty-three days to hearing, thirty-four days before transfer — are captured from the documents a resident actually receives. (2) The two state forms name the same agency differently: State Form 49669 (R8 / 1-19) says "Indiana State Department of Health" and State Form 49831 (R8 / 4-23) says "Indiana Department of Health"; the rule text also uses the older name. All stand as published. (3) The ombudsman office's own page and the department's notice form publish different addresses and different email domains for that office — LongTermCareOmbudsman@ombudsman.IN.gov on the office's page, and a Family and Social Services Administration address on the form, which also prints an ombudsman web address that is no longer the office's current page. Both are shown, reconciled nowhere. (4) The rule requires the facility to give written information specifying "The duration of the bed-hold policy under the Medicaid state plan during which the resident is permitted to return and resume residence in the facility." but states no number of days, and no state-plan duration was captured; the absence is stated rather than filled. (5) The rule's subdivision (9) opens "For health facilities, the written notice specified in subdivision (7) must include the following:" where the notice requirement is set out in subdivision (6); the cross-reference is the publisher's own and is reproduced as published. (6) The department's Resident Transfer and Discharge Information Center page returned HTTP 404 at the path found and is capture-pending. Capture pending: per the source map. Internet Archive: not yet submitted. Reviewer: Carrie Schluter, reviewed 2026-08-30. Corrections: hello@fieldassembly.net.